Long-Term Oncologic Outcomes of Laparoscopic Versus Open Radical Nephroureterectomy for Patients with T3N0M0 Upper Tract Urothelial Carcinoma: A Multicenter Cohort Study with Adjustment by Propensity Score Matching

Long-Term Oncologic Outcomes of Laparoscopic Versus Open Radical Nephroureterectomy for Patients with T3N0M0 Upper Tract Urothelial Carcinoma: A Multicenter Cohort Study with Adjustment by Propensity Score Matching

Background This study aimed to investigate the long-term oncologic outcomes of laparoscopic radical nephroureterectomy (LRNU) and open radical nephroureterectomy (ORNU) for patients with clinical and pathologic T3N0M0 upper tract urothelial carcinoma (UTUC). Methods Among 375 UTUC patients who under...

Full description

Saved in:
Bibliographic Details
Published in:Annals of surgical oncology Vol. 26; no. 11; pp. 3774 - 3781
Main Authors: Shigeta, Keisuke, Kikuchi, Eiji, Abe, Takayuki, Hagiwara, Masayuki, Ogihara, Koichiro, Anno, Tadanori, Umeda, Kota, Baba, Yuto, Sanjo, Tansei, Shojo, Kazunori, Mizuno, Ryuichi, Oya, Mototsugu
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01-10-2019
Springer Nature B.V
Subjects:
Adult
Aged
Aged, 80 and over
Bladder cancer
Cohort analysis
Female
Follow-Up Studies
Humans
Laparoscopy
Laparoscopy - mortality
Male
Medical prognosis
Medicine
Medicine & Public Health
Middle Aged
Nephroureterectomy - mortality
Oncology
Prognosis
Regression analysis
Retrospective Studies
Surgery
Surgical Oncology
Survival
Survival Rate
Urologic Neoplasms - pathology
Urologic Neoplasms - surgery
Urologic Oncology
Urothelial carcinoma
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background This study aimed to investigate the long-term oncologic outcomes of laparoscopic radical nephroureterectomy (LRNU) and open radical nephroureterectomy (ORNU) for patients with clinical and pathologic T3N0M0 upper tract urothelial carcinoma (UTUC). Methods Among 375 UTUC patients who underwent radical nephroureterectomy, this study identified 144 pT3N0M0 patients as cohort 1 after propensity score (PS) matching. Among 399 UTUC patients, the study identified 110 cT3N0M0 patients as cohort 2 after PS matching. Oncologic outcomes such as intravesical recurrence-free survival (IVRFS) and cancer-specific survival (CSS) were assessed by multivariate Cox’s regression analysis. Results Cohort 1 of pT3N0M0 UTUC had 3-year CSS and IVRFS rates of 67.9 and 52.7%, respectively, in the LRNU group, which were significantly lower than in the ORNU group (81.4%, p  = 0.039 and 71.6%, p  = 0.046). The multivariate Cox’s regression analysis identified the type of surgical approach (LRNU vs. ORNU) as one of the independent prognostic factors for CSS (hazard rate [HR], 1.88, p  = 0.043) and IVRFS (HR, 1.75, p  = 0.049). Cohort 2 of cT3N0M0 UTUC had 3-year CSS and IVRFS rates of 48.5 and 41.4%, respectively, in the LRNU group, which were significantly lower than in the ORNU group (65.8%, p  = 0.049 and 67.2%, p  = 0.047), and the type of surgical approach (LRNU vs. ORNU) remained as one of the independent prognostic factors for CSS and IVRFS. Conclusions Based on clinical and pathologic T3N0M0 UTUC populations after PS adjustments, LRNU resulted in poorer CSS and IVRFS than ORNU.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-019-07623-1